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Generally the hospital has checks and balances to prevent fraudulent billing (well not in this case, apparently).
My bigger issue with the RVU system is how it promotes sub sub specialization into procedure based specialties which are the antithesis of preventative medicine. The system valuee family medicine doctors the least despite the massive shortage in their services (especially in rural communities).
So, the surgeon that fixes the broken hip gets paid more than the doctor that gets the bone density scan done and starts meds that support bone health. The cardiologist that opens up the blocked vessel gets more than the PCP who takes the time to counsel on athersclerotic cardiovascular disease and controls risk factors medically and with lifestyle.
I'm not saying the surgeon / proceduralist shouldn't get paid more. I'm just saying that when your system incentivizes 'wait for the problem to happen and then fix it' you're going to have some bad health outcomes.